Registered incidence of acute upper respiratory tract infections diagnosed by primary care physicians in Poland - 5-year retrospective analysis of the national health insurance database.

INTRODUCTION AND OBJECTIVE: Upper respiratory tract infection (URTIs), caused by a variety of viruses and sometimes by bacteria, represents the most common acute illness in primary health care. The aim of the study was to explore the registered incidence of URTIs in Poland in the period between 2015-2019, and its burden on the health care system. MATERIAL AND METHODS: A retrospective analysis was carried out of all medical encounters in Poland registered within the national billing database of public healthcare services. Medical services provided due to acute URTIs were classified according to the ICD-10 codes. Registered Incidence Rate (RIR) was calculated yearly, in a 100,000 population. A generalised additive model was used to calculate the Incidence Rate Ratio (IRR). RESULTS: In the analysed 5-year period, acute URTI was diagnosed in 24.3 million patients (61.7% of the whole population registered in PHC). The RIR of all acute URTIs in PHC was 50,762/100,000/year. Nearly 99% of consultations in this group of patients were provided by PHC physicians. Only 0.8% were referred to an OSC consultation and 0.4% were hospitalised. In PHC, indeterminate URTIs were most frequently diagnosed. The estimated IRR for children aged 1-4 years was 1.65 (95% CI: 1.64; 1.66, p<0.01) and for men 0.79 (95% CI: 0.79; 0.79; p<0.01). In the studied period, the number of patients consulted for acute URTI decreased slightly in PHC, but significantly in specialist services. CONCLUSIONS: The registered incidence of URTIs in Poland burdens mainly PHC physicians. Women and children aged 1-4 years are more frequent users of medical services related to URTIs. It appears that strategies for increasing patient empowerment to provide efficient self-care reducing the utilisation of PHC services are needed.

The association between air pollutions and emergency hospitalizations due to COPD and asthma across 16 Polish cities: population-based study.

OBJECTIVES: In recent years numerous initiatives aimed at reducing air pollution have been undertaken in Poland. The general objective was to examine the correlation between air pollution measured by the level of particulate matter ≤10 µm in diameter (PM10) and emergency hospitalizations due to chronic obstructive pulmonary disease (COPD) and asthma in 16 Polish cities (capitals of the regions). MATERIAL AND METHODS: The authors aimed to diagnose the situation across 16 cities over a 5­year period (2014-2019). Data on the number of hospitalizations was retrieved from the national public insurance system, the National Health Fund. A total number of 22 600 emergency hospitalizations was analyzed (12 000 and 10 600 in 2014 and 2019, respectively). The data on air pollution was accessed via the public register of the Chief Inspectorate for Environmental Protection air quality database. The authors of this article have used the data on PM10 daily exposure in each of the 16 cities in 2014 and 2019. Statistical methods included: non-parametric tests, a 2-stage modelling approach for time-series data, and multivariate meta-analysis of the results. RESULTS: The results indicated that there was a statistically significant decrease in PM10 concentration in 2019 in comparison to 2014 in all cities, mainly in the autumn and winter season. However, the correlation between the improvement in the air quality and a decrease in emergency hospitalizations due to asthma and COPD turned out to not be as strong as expected. The authors observed a strong correlation between PM10 concentrations and hospitalizations due to asthma and COPD, but only when air quality norms were significantly above acceptable levels. CONCLUSIONS: Air pollution measured by PM10 concentration might be used as one of the predictors of the asthma and COPD emergency hospitalization risk, yet other factors like respiratory tract infection, health care organizational aspect, patient self-control, compliance and comorbidities should also be taken into consideration. Int J Occup Med Environ Health. 2024;37(1):110-27.